Written by Beata Anderson, Sonographer
NHS scans
What pregnancy scans are offered on the NHS? All pregnant women in England, Scotland, Wales and Northern Ireland should be offered at least two ultrasound scans on the NHS as part of their antenatal appointments schedule, known as the Fetal Anomaly Screening Programme (FASP). You might be offered more than two scans – for example, if there are concerns about your health or your baby’s growth. But for most women having straightforward, healthy pregnancies, the early pregnancy scan and the anomaly scan are all that are recommended.
The dating scan or First Trimester Screening will establish how far along you are and give you an estimated due date. It will check whether you’re expecting one baby or more and that your baby is developing as it should be at this stage. You should also be offered an antenatal screening test for Down’s syndrome, Edwards and Patau’s Syndrome. This is called the combined screening test, because it involves a blood test as well as the scan, and can be carried out between 11 weeks and 2 days and 14 weeks. It’s also sometimes referred to as the NT (nuchal translucency) scan. The test can’t tell for definite whether your baby has Down’s syndrome or Edwards or Patau’s syndrome but can identify whether they’re at risk. Based on the result, you might choose to have further tests to get a definitive answer. If you’d rather not know about possible risks, you can have the dating scan without the combined test. You should discuss this with your midwife prior to your scan appointment.
The anomaly scan Between 18 and 23 weeks, you’ll have your anomaly scan. The sonographer will take a detailed look at your baby’s heart, brain, upper and lower limbs, spine, face, kidneys and abdomen, placental site and amniotic fluid to check for a range of conditions. Not all problems can be detected by the anomaly scan, but if the sonographer sees any cause for concern, they will discuss their findings and possibly refer you to be seen by an obstetrician.
Private scans
Early pregnancy scanning as early as six weeks isn’t generally carried out on the NHS and the Royal College of Obstetricians and Gynaecologists (RCOG) recommends that scans shouldn’t be carried out before 10 weeks gestation unless they are clinically indicated. However, if you want a scan this early to see whether your pregnancy is developing normally, you could go to come to see us for an early pregnancy scan. We should see a heartbeat after 7 weeks of gestation, and if you have the scan towards the 10-week mark you can also see the baby’s head and where the limbs are forming. This scan can be reassuring if you’ve had a previous miscarriage or are feeling very worried, or you may be given one if you’ve had fertility treatment. However, it’s important to note that if you experience any problems like pain or bleeding early in your pregnancy you should always contact your GP, midwife or the Early Pregnancy Assessment Unit (EPAU) first. They might be able to give you a scan without you having to pay to have it done privately and also do other checks to make sure you and your baby are healthy. An early pregnancy scan can either be performed transabdominally but if your pregnancy is in the very early stages (less than 8 weeks) , you might be offered a transvaginal scan using a transvaginal probe.
Please note if you book an early pregnancy scan and you had a previous scan to leave 7 days between ultrasound scans so we can accurately for the growth of your pregnancy.
Gender scan
Sonographers can sometimes tell you the sex of your baby at your NHS anomaly scan at around 20 weeks. However, this is not the purpose of the anomaly scan and sometimes it’s not possible to tell the sex at that scan as your baby might be in a position that makes it difficult for the sonographer to see, in which case you may want to have a private scan to find out the sex. If you’re keen to know the sex of your baby, you can have a private gender scan from as early as 16 weeks. However, the further on in your pregnancy you are, the easier it is to get an accurate idea of whether it’s a girl or boy.
In our clinics we will also look for the babies’ heartbeats, movements, and take some images on thermal prints for you to keep. Measurements will be taken to check your baby is growing well. If the gender is proving difficult to determine we will ask you to go for a walk then try again. If we still cannot tell with enough certainty then we will offer you one complimentary rescan.
We have optional extras available to purchase on the day; a USB stick containing your images and our beautiful handmade gender reveal crackers containing either blue or pink confetti. (subject to availability).
Growth scan
Fetal Growth or Well-Being scans can be performed at any stage after 24 weeks of pregnancy. This scan is for women who are concerned about their pregnancy for any reason. A growing baby is a healthy baby so sometimes they are done in a sequence. During this scan we measure the baby’s head, abdomen and limbs, and estimate the baby’s weight. This gives a guide to how big your baby will be at birth. We also look at how the baby is moving, the amount of amniotic fluid, and where the placenta is. We will also assess the Doppler blood flow in the umbilical cord blood vessels. It is also possible to tell the sex of your baby from this scan, but this becomes more difficult as you approach the end of your pregnancy.
The NHS offer the following routine growth ultrasound scans: One at approximately 12 weeks and the other at 20 weeks of pregnancy. A well-being and growth scan is not usually offered on the NHS unless:
- The placenta is low at the 20 week scan
- An abnormality was seen
- If the baby was measuring too small or big at the 20 week scan
- Previous premature delivery
- Previous pre-eclampsia
- Diabetes or Gestational diabetes
- If the midwife measures the symphysis fundal height, and it is 2 weeks or more less than expected.
The indications or reasons for having your Growth scan at Somerset Early Scans clinic (ideally performed any time after 24 weeks of pregnancy) are:
- As a second opinion
- As reassurance
- Calm and relaxing environment
- Reduced movement of the baby
- Bleeding or fluid loss
- To check baby’s position
What structures of the baby can be checked?
The fetal anatomy should have been checked in detail at the 20 week mid-trimester anomaly scan on the NHS. Depending on the fetal position, the stomach, kidneys and bladder are checked after 24 weeks.
Aims of the wellbeing scan:
- Confirming the fetal position eg. breech.
- Measuring the size of the fetal head, abdomen and thigh bone and calculation of an estimate of fetal weight.
- Examinations of the movement of the fetus.
- Checking the placental position and appearance.
- Measurement of the amount of amniotic fluid.
- Assessment of blood flow in the umbilical cord by Doppler ultrasound to assess placental function.
Scan results will be given to you at the time of your visit and a copy of the report and growth charts will be given to you. In the event of an abnormal result, we will contact your midwife. Please bring your maternity handheld notes along with you to the appointment.